What’s Your QI IQ? Residents Revolutionizing Medicine

As frontline care givers, resident physicians are in a unique position to identify – and correct – unsafe and inefficient practices that lead to less than optimal care, drive up healthcare costs and, in some cases, result in tragic and preventable medical errors.

In the past year, the CIR Policy and Education Initiative (CIR PEI) has sponsored four What’s Your QI QI? conferences, attracting residents and faculty from throughout the New York area.

“As physicians on the frontline, we know our patients and we want the best for them. That’s why we’re leading quality improvement and patient safety endeavors in our hospitals,” said Dr. David Eshak, an internal medicine resident at Jacobi Medical Center in the Bronx and a CIR regional vice president.

How to be Scholarly in Quality Improvement: November 23, 2013
Co-sponsored by the Albert Einstein College of Medicine, the first conference in the series focused on publishing QI projects and attracted more than 120 attendees. Dr. Greg Ogrinc of Dartmouth Medical School led a hands-on workshop on how to plan conduct and publish QI projects using the SQUIRE (Standards for Quality Improvement reporting Excellence) Guidelines. Dr. Karyn Baum, from the University of Minnesota, focused on where and how to get published including how to build a career in QI.

Unlike other types of research, Dr. Ogrinc pointed out, “QI is not the same as drugs, tests, clinical procedures. [It] is performance change, driven by experiential learning, is context-dependent and problems can occur at various organization levels.” Residents especially experience challenges in conducting their research and finding opportunities for publishing. Rejection, rewriting, working as team, communication and developing a plan for publication are all keys to successfully getting published during residency. Dr. Baum’s tips on finding out where and how to get published include:

Paying attention to departmental/specialty conferences focused on research

Familiarizing yourself with journals that publish QI

Using your published posters as a springboard

Familiarizing yourself with journal submission guidelines

How to Provide Cost Conscious Care: January 18, 2014
The Costs of Care team, ABIM Foundation, Albert Einstein College of Medicine, and CIR PEI teamed up for an exciting training focused on providing cost-effective care to patients. To open the conference, Daniel Wolfson of the ABIM foundation asked the room of more than 100 residents and faculty to stand if they had seen a patient harmed by unnecessary care; only one person in the room remained seated.

Mr. Wolfson suggested that when it comes to tests, attendings should ask their residents, “Why do you need this test?” as opposed to asking “why didn’t you take these tests?” Of the $700 billion a year wasted on healthcare in the U.S., unnecessary treatment accounts for about 30 percent of that cost—or $200 billion.

The Costs of Care team highlighted the importance of understanding the impacts of cost on patients and how financial difficulties are often mistaken for “patient non-compliance.” Dr. Vineet Arora, Director of Education, Costs of Care, and an expert in clinical behavioral change, suggested that simply asking patients if they have difficulty paying for their medications is a simple way to determine a course of action in treatment. The team included several tools for practicing medicine with more value. Cost-saving strategies included:

Splitting pills (consumer report has created a list on medications that are safe to split)

The Costs of Care team also provided participants with the “COST” tool to help physicians determine barriers in their home institutions in order to begin to change the culture of their programs to include more cost-consciousness.

The final workshop in the series will take place on April 26. How to be a Lead Agent of Change: From Bedside to Transformative Care will teach caregivers effective communications skill to overcome the barriers to patient safety and transparency.

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Your Uninsured Patients May be Eligible for Free or Lower-Cost Healthcare

During this year’s Open Enrollment period under the Affordable Care Act, your patients can apply for the first time, renew their current plan, or go shopping for a better option.

Here are the dates you need to keep in mind!
November 15, 2014: Open Enrollment begins. Apply for, keep, or change your coverage.
December 15, 2014: Enroll by the 15th if you want new coverage that begins on January 1, 2015. If your plan is changing or you want to change plans, enroll by the 15th to avoid a lapse in coverage.
February 15, 2015: This is the last day you can apply for 2015 coverage before the end of Open Enrollment.

For more information, or to apply or change coverage, tell your patients to go to the following websites: